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Repeated digital nerve block for pain control after tenolysis
R Kirchhoff1, P B Jensen, N S Nielsen
1Section for Hand Surgery, Gentofte Hospital, University of Copenhagen, Denmark.
Summary
Immediate pain-free mobilization after flexor tendon surgery in Zone II is achievable. This technique involves instilling bupivacaine, a local anesthetic, along the tendon sheath to reduce post-operative pain.
Area of Science:
- Orthopedic surgery
- Pain management
- Hand surgery
Background:
- Zone II flexor tendon injuries often involve complex tenolysis or tenosynovectomy procedures.
- Post-operative pain and stiffness can significantly impede early mobilization, potentially leading to adhesions and reduced functional outcomes.
Purpose of the Study:
- To present a novel method for achieving immediate, pain-free mobilization following Zone II flexor tendon surgery.
- To evaluate the feasibility and efficacy of percutaneous bupivacaine instillation for post-operative pain control.
Main Methods:
- A technique involving percutaneous instillation of bupivacaine into the flexor tendon sheath is described.
- A thin catheter with an antibacterial filter is utilized for precise drug delivery.
Main Results:
- The described method facilitates immediate post-operative mobilization without significant pain.
- This approach aims to prevent the formation of adhesions and improve tendon gliding.
Conclusions:
- Percutaneous bupivacaine instillation offers a promising strategy for enhanced recovery after Zone II flexor tendon surgery.
- This technique supports early, pain-free mobilization, potentially improving functional outcomes in hand surgery patients.